F.A.Q. (Frequently Asked Questions)

If your question is not answered here, please feel free to contact me at info (at) samallencounseling.com. Emails are generally answered within 24 hours (allow more time on weekends and holidays).

1. You're located in North Carolina, I'm not-- how do I arrange a session with you?

I actually end up working with more clients from outside NC, so I've expanded my telephone counseling and consulting services. This works well for clients outside my geographic area, where no therapist is available, as well as for those who are more comfortable speaking "anonymously", and for others who simply feel that telephone sessions are more convenient and cost-effective for them. I also travel fairly often, so please email me at appointments at samallencounseling.com if you're interested in scheduling in-person consultations for yourself or your organization.

2. I was referred to this site for gender-related counseling. Are you a gender specialist?

Yes. I've worked with individuals, groups, partners, parents, schools (including university medical schools), authors, law enforcement, courts, attorneys, corporations, documentary film and television producers, and all the major U.S. gender conferences, regarding LBGTQI (particularly transgender) topics, for over 25 years. Please see the credentials section for additional information. I served as co-facilitator of one of the country's first transgender support and information groups, beginning in 1983, and founded/facilitated specialized transgender psychotherapy groups in the early 1990's. I enjoy working with individuals who are exploring their own gender path, or seeking information and support to help a loved one (or to deal with their own issues related to a loved one's gender journey).

3. My spouse (or Significant Other, family member, friend) is exploring transgender issues and I need more information to help me understand this. Can you help?

4. I don't know that I want or need "counseling", but I do need information and someone to talk to. What do you suggest?

Many people who don't necessarily want or need "counseling", per se, still feel that they need more information and support than they can get from the internet or books. Many individuals live in geographic areas that lack support groups, or other resources. Still others find that the local groups aren't for them, for any number of reasons-- the group's focus may be social while the individual's focus is on obtaining information. Or vice versa. Or privacy and confidentiality concerns may make going to a "public" group feel unsafe. Fortunately, there are more resources than ever before, and people generally feel safer "reaching out" than they used to. My clients express that they choose face-to-face or telephone services with a professional counselor as opposed to peers (or in addition to peers), because they want to maintain their privacy, consult with an objective vs. involved party, and/or for simple efficiency-- surfing the internet or visiting various groups in search of the right fit eats up valuable time. With professional services, you can "get right to the point", and you're assured that your interests and needs come first.

5. If I decide to see a therapist regarding my gender transition or related issues, is it necessary for this person be a "transgender specialist"? What should I look for? What are some "red flags" / What should I avoid?

A clinically competent, experienced psychotherapist who is well-versed in transgender matters, and has successfully worked with other clients on these issues should be able to help you, regardless of his or her specialty. The two most important caveats I would extend to you here are Make sure that the individual has legitimate therapist's credentials & experience, and 2) Beware of paying to educate your therapist. If your hard-earned dollars are going into counseling sessions where you find yourself explaining "the basics" of transgender issues to your therapist--- please consider redirecting your energies toward locating a gender specialist. All therapists are governed by a code of ethics that requires them to refer you to a specialist or other qualified professional, if they aren't knowledgeable in your area of clinical concern. That said, in my professional opinion, you are still better off with a great psychotherapist (highly trained, insightful, experienced, clinically-focused) who may not be an expert in transgender matters, vs. a poorly trained, relatively unskilled or mediocre therapist--- or worse, someone who isn't actually a bonafide therapist at all--- who nevertheless lays claim to the title "gender specialist". These days, the facts are out there about transgender subject matter--- medical information, procedures, hormones, names and contact information for physicians, etc. You can usually find these online and/or in books. I've trained and supervised many social workers, therapists, and interns over the years, and I've found that while a smart, observant, intuitive, insightful therapist can learn facts about any condition or population--- and can therefore adapt and be able to help almost anyone---it's much harder, if not altogether impossible, to train an individual to be a great therapist if the raw material isn't there to begin with. The "desire to help people", alone-- without good clinical insight and skill-- is not enough. Psychotherapy is part art, part science. If a loved one or a good friend was seeking help with transgender issues and had a choice between an excellent (open-minded) therapist who needed to read a few more books to get more facts about TG topics, vs. someone advertising themselves as a "gender specialist" with dubious credentials or who lacked a solid background as a clinical therapist--- I'd recommend that the person go with the former choice.

Also, do ask if the therapist (professional counselor, social worker, or psychologist) is specifically licensed as a therapist--- your insurance will not cover services by, nor will surgeons or other medical professionals be likely to accept letters from unlicensed providers. Degrees in other disciplines (such as anthropology, sociology, nursing, etc) do not qualify individuals to bill themselves as "therapists" or mental health professionals------ the time spent working with such folks may still be helpful to you, if you have a good rapport, but if you are seeking letters (for hormones or surgery) or referrals to continue a gender transition, you may find that after seeing an unlicensed provider, you have to "start over", or seek additional letters from supplemental providers. I have recently heard of surgeons and other MDs who initially accepted letters from "gender specialists" on face value (assuming the intials after the person's name represented the appropriate degree and training), but who are now exercising more caution and rejecting letters from providers who later turn out to be marginally-credentialed providers or "coaches"---- for you, this may translate into a requirement for additional, supplemental letters.

Beware of providers who may appear to have discovered something of a "golden goose" in terms of "specializing" in this area without adequate training or credentials. The therapist should have a legitimate background with concrete therapist credentials--- some red flags for transgender people or their loved ones may be providers with alternative titles such as "peer counselor", "guide", "peer guide", "gender guide", "gender coach","helper", "helping guide". In the state of North Carolina, the provider should have one or more of the following initials after their name: PhD (verify that the degree is specifically in Psychology or Counseling), LPC (Licensed Professional Counselor), NCC (National Certified Counselor-- alone, not adequate for independent practice, as it is not a license, but may appear in addition to licensure, indicating additional credentialing in the mental health field), PsyD (Doctorate-level Psychotherapist), LCSW (Licensed Clinicial Social Worker-- not all social workers are sufficiently trained as therapists, but many are), or MD (verify a specialty as a psychiatrist). If the provider does not carry any of these credentials, it's unlikely that he or she is, indeed, a "psychotherapist", "therapist", or "counselor"--- they may have had some training in mental health subjects but not graduated from or even attended a training program specifically for therapists. If you receive "alternative explanations" ("Well, my degree is in another area, but I worked on the psychiatric unit of a hospital"), you would be advised to look elsewhere for a properly credentialed therapist.

Beware of individuals whose degrees came solely from Diploma Mills! (vs from legitimate training programs). Diploma Mill "credentials", in the counseling or therapy field, just as in any area of healthcare or medicine, spell "s-c-a-m". Anyone with a credit card can purchase a "degree" from a Diploma Mill--- the sources of these virtually worthless pieces of paper operate as businesses rather than schools, though they typically tack the word "university" onto to their name. They are in the business of selling bachelor's, master's, and even PhD degrees to individuals who can't or who elect not to go through the more rigorous training they'd face in a legitimate college or university. Typically, these businesses have no entrance requirements whatsoever, require no prerequisite education, and similarly, no "student" fails the program or fails to receive a "degree"--- as long at the credit card transaction goes through. The student is purchasing rather than earning a degree, in these cases, so "graduation" is a given. While this is a perfectly fine option for a person who is seeking additional education for personal enrichment and entertainment, it is not considered a legitimate or credible path to becoming a practicing psychotherapist. Try to find out this information before you spend the money for a first appointment.

Along these lines, do remember that anyone can buy a website and hire a person to scour the internet searching for legitimate therapists' sites, then simply cut and paste the "right" words, phrases, and terms onto the fake site. Instant "therapist" or "transgender specialist". Unfortunately, the site you're now reading has inadvertantly provided "source material" for a few unscrupulous individuals who were not therapists, but who decided to claim that title, for monetary gain. That is, in fact, the reason that this site does not contain more specific and detailed information about therapy, treatment philosophy and methods, exact timeframes for providing referral letters to other healthcare professionals, etc. I'm happy to provide that information to individuals (usually via phone), always at no cost. But sadly, providing the information on a website provides a blueprint for an unscrupulous person to build their own website specifically designed to con you. Having heard from so many people who feel they've fallen victim to these situations and wasted money before catching on, I aim to limit the amount of "help" I provide to scammers. [2016 Update: I had hoped that some of the above scams had become less common. Sadly, I've recently learned of a therapist practice in North Carolina where the practice owner now instructs therapists in her practice to comb the internet in search of GLBTQI therapists' websites, then cut & paste the borrowed verbatim text into their own website profiles, in order to more effectively present themselves as "GLBTQI specialists" or "transgender specialists". The detailed, "personal" descriptions of the therapists were actually written by other therapists, at totally different practices or clinics, and do not have any connection to the therapist whose name appears along with the description! The "About Us" and "Let Me Tell You About My Specialties & My Therapeutic Approach" sections were merely cut from some other therapist's profile, and pasted in. In this type of unscrupulous practice, especially due to the recent success & mainstreaming of media phenomena such as Caitlyn Jenner and the tv show "Transparent", transgender, gender non-conforming, or gender-questioning children, adolescents, and adults (and their families) are viewed as financially profitable "Flavor Of The Month" commodities.]

~~~~~~ Please feel free to send our office an email to let us know if you run across other websites using "cut and paste" information taken from this site ~~~~~~

Exploitation seems to be a common occurrence for individuals who are seeking help for transgender-related concerns. Again, this problem has increased in recent years because this area of specialization has recently begun to be seen as a "golden goose" to a few individuals who know that they do not possess valid credentials or who are credentialed but lack sufficient training & experience in working with TG or gender non-conforming individuals--- but who believe they can get away with this by targeting a vulnerable population, eager, and sometimes desperate, to find transgender-friendly providers. Don't be shy about asking for information on credentials and professional experience. [Update: A situation with an individual who was fraudulently claiming education & credentials as a therapist and "transgender specialist", has resolved. The individual was under investigation, in the state of Georgia, for practicing without a license or credentials. His "practice" closed in 2010, shortly after opening.]

You may not need "therapy" at the moment--- but if you do, somewhere along in your transition journey, will a paraprofessional have the knowledge and skill to help? When I'm contacted by individuals who express regret at "wasting time & money" seeing providers who were not honest about their lack of actual training and credentials, some frequent comments are "I didn't know what to look for", "I didn't know what to ask about their experience", " was suspicious but the person seemed nice". Another frequent report is that the "therapist" (who turned out not to be a therapist at all, or to be brand new to the field, with inadequate professional experience) engaged in a sales pitch that convinced the individual "you don't need a therapist-- if you think you're transgender, you are, and that's all you need to know". Seeing a therapist and participating in therapy does not make you "crazy", "mentally ill", etc, and you may walk in the door with clear goals, perhaps gender transition goals, already defined--- do you prefer to pay someone for being "a nice person", "a friend", and rubber-stamping those plans? (If so, you may be able to get this type of support from an existing friendship, a trusted confidant, a peer, someone from a TG support group or online forum--- for free). If you're seeking an objective yet supportive alliance with a trained professional, then make sure that's who you're paying. This is the time to ask yourself the tough questions---- which a bonafide therapist should ask you. An individual who is not adequately trained or experienced may know how to provide the "friendly support" aspect of the equation, but may not know the tough questions to ask, how to recognize or treat other mental health problems, or know how to help you get through a crisis, should one arise. In considering therapy, counseling, or other professional services, you should ask yourself what you really need and want from the interaction.

6. What is your fee scale and what payment options do I have?

Face to face psychotherapy, counseling, and consulting is billed at $150 per 50-minute hour. For more in-depth consultations (to groups, organizations,etc) involving longer sessions and travel, feel free to contact me appointments at samallencounseling.com to discuss options . Clients have three options for telephone counseling:

20 minutes - $65

40 minutes - $95

60 minutes - $115

Please send me an email if you'd like to arrange a free phone consultation to discuss services and the options that might be a good fit for you.

7. Do you have other specialties? Do you accept clients with issues unrelated to LBGTQI concerns?

Absolutely. My professional background spans more than 25 years in mental health and social services settings, from university counseling centers, to psychiatric hospitals & crisis facilities , to private outpatient settings, working with all types of individuals from the severely mentally ill to the general population & people with "average, everyday problems". I have extensive experience in areas from substance abuse, anxiety & depression, to working with gang-involved and "at risk" youth, and the entire range of concerns typically seen in mental health settings. I have served as Clinical Director, Clinical Supervisor, Program Director, & Training Coordinator for a number of mental health programs, and frequently provide clinical training to therapists, social workers, case managers, and paraprofessionals.

Please note that not all problems can be treated or dealt with via telephone counseling, so if your issues are not appropriate for this type of work, you have the option of arranging face to face office visits, or seeing a therapist in your geographic area, if it's not feasible for you to be seen in NC. I do not currently offer emergency services counseling; if you are in crisis, call 911, go to any nearby hospital ER, or contact your local mental health center (typically listed in the government or "blue pages" section of the phone book).

I especially enjoy working with people who define themselves as living "outside the box", individuals who may not always feel that they completely belong to or are understood within the mainstream. For this reason, many of my clients are artists, entreprenuers, musicians, performers, "creative types", lesbian/bisexual/gay/transgender, questioning, intersexed, people who identify as members of the kink or leather community, are in polyamorous relationships, or people who self-identify as "alternative" in some way. I'm sensitive to the fact that individuals who identify or who are perceived as "different" have not always been treated well by the mental health profession. I'm also dedicated to working with the individual's spiritual beliefs and honoring that aspect of the whole person. I'm familiar with most areas of metaphysics and alternative spirituality, and am certified in hypnotherapy (including training under Henry Leo Bolduc, Henry Reed, and Marjorie Reynolds). Please feel free to contact me about in-person hypnotherapy and past-life work.

8. Privacy and confidentiality are my biggest concerns when it comes to "talking to someone".

Privacy and confidentiality are essential to all counseling, but they are often of particular (and understandable) concern to individuals with LBGTQI issues. Your sessions are confidential. For telephone counseling or consulting, I needn't know your real name, if that's your preference (for example, if your credit card lists you as "J.B. Smith" I won't have any identifying information beyond that). In fact, many people who choose telephone counseling or consultation do so because of the feeling of additional anonymity provided by that option. The exceptions to this are the same as with any counseling situation-- therapists and all health professionals are required to make a report if you inform them that you are going to harm yourself or someone else, or if a minor or vulnerable elder individual is being abused.